MEDICARE: MERLYN PENA-SOLIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	99616	CA

General Provider Information

NPI Number	:	1104497254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERLYN PENA-SOLIS

Provider Business Mailing Address
First Line	:	3641 7TH AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-4107
Country	:	US
Telephone Number	:	323-485-8748
Fax Number	:

Provider Business Practice Location Address
First Line	:	3641 7TH AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-4107
Country	:	US
Telephone Number	:	323-485-8748
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2021
Last Update Date	:	12/01/2025

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Directions to “ MERLYN PENA-SOLIS ” Practice Location

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